应用颈椎螺旋融合器前后路一次性手术治疗脊髓型颈椎病

Anterior and Posterior Approaches in One Stage Operation for Treatment of Cervical Spondylotic Myelopathy with Cervical Spine Threaded Fusion Cage

目的 :对合并发育性颈椎管狭窄的严重的多节段颈椎间盘突出及不稳的脊髓型颈椎病患者应用颈椎螺旋融合器前后路一次性手术治疗 ,并进行分析。方法 :对 7例合并发育性颈椎管狭窄的多节段颈椎间盘突出及不稳的脊髓型颈椎病患者先行后路颈椎单开门椎板成形术或颈椎板切除减压术 ,然后前路行颈椎间盘、骨赘切除减压颈椎螺旋融合器植入术 ,术后采用日本整形外科学会标准 17分法进行测评。结果 :平均随访时间 12个月 ,7例患者术后均有不同程度皮肤感觉改善和四肢肌力提高 ,其中 2例大小便障碍者括约肌功能恢复 ,脊髓功能的平均改善率为 76 .2 %。结论 :本手术方法减压彻底 ,具有安全性 。

Objective: To discuss the procedure and the clinical significance of one stage operation accomplished through posterior and anterior routes with threaded fusion cage (TFC) for the treatment of cervical spondylotic myelopathy (CSM) of severe multi-segmental cervical disc herniation, intervertebral instability and spinal canal stenosis. Methods: The posterior approach was carried out with laminoplasty or laminectomy firstly on 7 patients, then the anterior intervertebral decompression was executed and the TFC was planted. Assessment after surgery was based on the recovery rate using the scoring system of the Japanese Orthopaedic Association. Results: The average follow-up were 12 months. After operation 7 patients′ skin sensation showed improvement and limb muscle strength elevated. The overall mean improvement was 76.2%. Conclusion: The procedure is decompressed completely and carried safely. The instability of the cervical spine is resolved.